Mixed angina pectoris

Mixed or variable threshold angina pectoris is a syndrome in which there is substantial variation in the magnitude of physical activity that induces anginal chest pain.

Dynamic vasoconstriction which is superimposed on fixed atherosclerotic coronary artery obstruction has been postulated as the underlying pathophysiologic mechanism for the changes in exercise threshold in mixed angina pectoris.

• The essential clinical feature of mixed angina is a substantial variation in the degree of physical activity that induces angina.
• This group of patients may also experience nocturnal angina on certain occasions.
• Anginal episodes may also occur upon exposure to cold, during periods of emotional stress, or after meals.

• The treatment is the same as in chronic stable angina.

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